The drastic growth of the handheld ultrasound equipment market is a result of a shift toward smaller and smarter medical imaging technology. From 2016 to 2017, handheld revenues grew over 18%, outpacing all other ultrasound product categories. Handheld ultrasound systems have been on the market for nearly a decade and are now booming due to numerous growth drivers, including portability and affordability, and solutions to previous obstacles, like insufficient image quality and lack of technological infrastructure and training.

China was the second-largest ultrasound market in the world in 2017, growing an impressive 15.8%. China’s ultrasound market has grown more than 10% nearly every year since 2009 when Healthy China 2020 policies were first implemented, but its landscape looks much different now than it did a decade ago. New reform initiatives are shifting ultrasound funds toward underdeveloped regions and healthcare facilities. Policies that once restricted private hospital market growth have been lifted.

Radiology remains the largest clinical application, but the global ultrasound market is evolving as it grows, and non-traditional and point-of-care applications are now at the forefront of product development. In 2017, cardiology ultrasound growth outpaced other traditional applications and technology development boosted the non-traditional and point-of-care ultrasound markets. Primary care remained a major emphasis for manufacturers and end-users.

Three trends have dominated ultrasound product launches of the past year – artificial intelligence capabilities, handheld systems, and designing for the end-user’s comfort. Holley Lewis, lead analyst for the Ultrasound Intelligence Service, discusses the short-term outlook for these trends and their impact on the global ultrasound market.

Global ultrasound revenues totaled $6,644.1 million in 2017 and grew 7.6% from 2016, representing the largest year-over-year market growth rate in several years. Revenue growth was driven by successful markets in China and the United States, countries which accounted for 45% of the global market in 2017. Additionally, growth returned to developing markets as Brazil bounced back from its recession, and healthcare infrastructure upgrades drove demand in several Eastern European and Middle Eastern countries.

The 2018 European Congress of Radiology (ECR) kicks off today in Vienna. ECR is one of the leading global events in radiology, and the congress will welcome nearly 27,000 attendees from over 140 countries. Three hundred exhibitors, 50 of which specialize in ultrasound, will display radiology equipment and products, and the largest international companies will host ‘Satellite Symposia’, company-sponsored educational sessions, during the congress. The on-show guide to the congress provides an outline for each Satellite Symposia and shows that ultrasound companies will focus on three technologies during the sessions—fusion imaging, contrast enhanced ultrasound (CEUS), and shearwave elastography. These technologies and their influence on the global ultrasound market are defined and discussed below.

Growth for x-ray, ultrasound, MRI, and CT equipment will be driven by a variety of unique factors, but several trends will affect future revenues for the entire medical imaging equipment market. Three of these trends—the aging global population, the changing US healthcare culture, and the emergence of healthcare markets in developing nations—are highlighted below and followed by IHS Markit’s advice for capitalizing on these trends.

Global revenues for interventional cardiology ultrasound equipment were $131 million in 2016 and are forecast to reach $161 million in 2021. Global demographic changes, fears regarding radiation dose, and the increasing accessibility of ultrasound are driving growth for the interventional cardiology market, and interventional cardiology advancements are driving growth for minimally invasive procedures.

With many trends influencing the growth of the ultrasound market, it is interesting to analyze the subsequent impact on the sales channels customers use to purchase equipment. As with most medical technology, the underlying factor of shrinking healthcare budgets is shaking up the ultrasound equipment product mix. The focus is on providing the best level of care and reducing high-cost procedures through prevention rather than cure; this is changing the way in which healthcare is provided. Not only are healthcare professionals seeking products that improve the return on investment, but also products that can be used in non-traditional applications; ultrasound equipment is now used by a greater variety of professionals than ever before. This is subsequently affecting the demand for user training and for receiving information directly from manufacturers.

The growing popularity of quick examinations at the point –of –care is paving the way for the adoption of handheld ultrasound systems. These are portable ultrasound systems designed to be held by the doctor or technician conducting an imaging examination. This product category includes smart devices running mobile applications that operate as functioning ultrasound systems.

Global ultrasound revenues totaled $6.16 billion in 2016 and are forecast to grow at a CAGR of 3.6% from 2016 to 2021. The following table shows the total ultrasound revenues for Europe, Middle East, and Africa (EMEA), the Americas, and Asia Pacific in 2015 and 2016:

The European Congress of Radiology (ECR) convened in Vienna on March 1–5 2017. ECR provided an opportunity for leaders in the ultrasound industry to meet and discuss the future of the region’s ultrasound market. The EMEA ultrasound market will face several barriers to growth in 2017. The upcoming presidential elections in Germany, France, and the Netherlands are already creating a lull in ultrasound system sales as these large governments prepare for transition. Shrinking budgets in both the public and private sectors are forcing healthcare providers to delay purchases of ultrasound systems, and increased competition from Asian-based manufacturers is causing additional disruption in the market.

The way in which ultrasound systems are marketed and purchased across the world is changing. Increasingly, and especially in developed markets, ultrasound systems are being designed with a specific clinical application in mind. When ultrasound was first introduced as a medical imaging tool in the mid-20th century, healthcare providers used one system for all clinical applications.

The 102nd Scientific Assembly and Annual Meeting of the Radiological Society of North America took place from 27 November to 2 December 2016 in Chicago. On Monday, 28 November, RSNA announced the results of a large study that found no evidence supporting age-based mammography cut-off.

The global ultrasound imaging equipment market is estimated to have been worth $6.16 billion in 2015; an increase of 1.2% from 2014. This rate of growth is lower than previously forecast, which is primarily due to the impact of a strong US dollar and other foreign exchange fluctuations, which affected the sales of foreign US subsidiaries. The market also experienced a period of highly competitive pricing which lowered average sales prices (ASP), particularly in Latin America and Europe. For some vendors, this ASP erosion was further exacerbated by the effects of shifting foreign exchange rates. Stronger growth is predicted for 2016 because of new product launches from Carestream, Fukuda Denshi, Hitachi-Aloka, and VisualSonics (Fujifilm SonoSite), and because of increased volumes in point of care and obstetrics applications. On a unit volume basis, shipments were up by 4% over 2014. The results for 2016 are expected to be closer to a 5% increase. Growth in the market through 2020 is being driven by uptake of mid-range and high-end cart-based systems in both emerging and developed markets for use in traditional applications. Uptake will also be bolstered by further development of the use of compact ultrasound systems in point-of-care (POC) applications.

Software solutions have long been an important consideration for purchasers of medical imaging equipment. The initial focus has typically been on software supporting storage and communication of digital images through ‘digital imaging and communications in medicine’ (DICOM) capabilities and ‘picture archiving and communication systems’ (PACS). Widespread adoption of electronic medical records (EMRs) has helped to drive recent developments in software, which have expanded interest in artificial intelligence, image reconstruction algorithms, and computer-aided detection and diagnosis. Ultimately, these systems have the same aim: to recognise clinical problems and abnormalities in digital images to assist diagnosis and improve results.

As the year draws to a close, one of the highest growth markets for ultrasound imaging equipment has taken a significant downturn. The Brazilian ultrasound market has hugely underperformed against the IHS forecast due to a poor economic climate. As a result, IHS has amended the top-level initial five year forecast for the market.

More ultrasound systems were sold in 2014 than CT, MRI and X-ray combined. Over 170,000 ultrasound systems were estimated to have been shipped globally in 2014, accounting for over 60% of the total medical imaging market. Strong growth is forecast in the ultrasound market, with over 1 million ultrasound systems projected to be sold during the period 2014 to 2019. Uptake will be driven by demand in traditional applications such as radiology and OB/GYN in developing regions and the expanding use of ultrasound in new applications including MSK and critical care, and procedural guidance in mature markets.

In May 2014, the National Healthcare and Family Planning Commission (NHFPC) launched the ‘Excellent Domestic Medical Device Selection’ program. This is the first government approved open selection of domestic medical devices in China in order to form the ‘Excellent Domestic Medical Device’ catalog.
In such a large potential medical electronics industry, fighting for more market share for local brands will always be a core focus of the Chinese government creating an increasingly challenging environment for multinational suppliers.